VOCAB CNS PHARM
Terms
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- Acute Pain
- Pain that is sudden inonset usually susides when treated less than 3month
- Adjuvant analgesic agent
- A drug that is added as a second drug for combined therapy with a primary drug and may have additive analgesic properites
- Partial agonist
- binds to a receptor and causes only limited actions
- Analgesics
- Medications that relieve pain without cuasing loss of consciousness
- Antagonist
- An agent that binds to a receptor and prevents (blocks) a response
- Central Pain
- Pain resultin g form any disorder that cddauses central nervous system
- Gate Theory
- The most common and well described theory of pain transmission and pain relief. It uses a gate model to explain how impulses from damged tissues are sensed in the brain
- Neuropathic pain
- Shingles
- Nonopiod analgesics
- Analgesics that are not classified a opiods
- Nonsteroidal antiinflammatory drugs (NSAIDs)
- A large chemically diverse group of drugs that are nalgesics and also possess antiinflammatory and antipyretic actifvity but are not steriods
- Opioid analgesics
- Synthetic narcotic agents that bind to the mu, kappa, and delta receptors to relieve pain but are not themselves derived from the opium plant
- Opioid tolerance
- A physiologic reult of long-term opioid use in which larger doses of opiods are required to maintain the same level of analgesia
- Pain threshold
- The level of stimulus that results in the preception of pain
- Referred pain
- Pain occurring in an area away from the organ of origin. ex. left arm in heart attack
- Somatic pain
- Pain thatoriginates from skeletal muscles, ligaments, or joints
- Vascular Pain
- Pain that results from pathology of the vascular or perivascular tissues ex migraine headache
- Visceral pain
- Pain that originates from organs or smooth muscles
- Chronic Pain
- Arthritis last more than 3months
- Superficial Pain
- Skin
- Opioid
- Mathadone hydorchloride (Dolophine)
- Opioid Antagonist
- Naloxone hydrochloride (Narcan)
- Three chemcical clsses of opioids
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Morphine
Mepridine
Methodone - Anesthertics
- Are agents thaqt depress the CNS which in turn produces depression of consciousness, loss of responsiveness to sensory stimulation or muscle relaxation
- Balanced Anesthesia
- The practice of using combination of drugs rather than using a single agent to produce anesthesia Common combinations include use of sedative hypnotic and antianxiety agent an analgesic, an antiemetic and anticholinergic
- Agonist
- binds to a receptor and causes a response
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Opioids
Indications: - Alleviate moderate to severe pain.
- Adjuvant Analgesic Agents
- Assist the primary agents in relieveing pain ie; NSAIDS, Antidepressants, anticonvulsants and corticosteroids (cancer pains)
- Opioids
-
Morphine Sulfate
Codeine Sulfate
Demerol
Dolophine - Opoid antagonist
-
Naloxone hydrochloride (Narcan) Antidote
Naltrexone hydrocholoride -
Opoid Antagonist
Side Effects - CNS depression, Cardio, GI, Genitorurinary, Resp. Itchy
- Nonopioid Analgesic agents
-
Acetaminophen, NSAIDS
Antipyretic an analgesic -
Nonopioid
S/A effects - rash n/v, nephrotoxicities, large amounts cause hepatic necrosis
- Antidote for Acetaminophen
- Acetylcysteine
- Two categories of anesthetics
- inhalded and injectable
- Anesthetic drug effect
- orderly and sstematic pralysis of the CNS
- Anesthetic Contraindications
- Drug allergy, pregnancy, narrow angle glaucomea, hypetension from prior use.
- parenteral anesthetics
- can be administered into the CNS by various spinal injection techniques (lidocaine, mepivacaine, procaine,a nd tetracaine)
- Neuromuscular blocking Agents
- Prevent nerve transmission in certain muscles, leading to paralysis of the muscle
- Central Nervous System Depressants
- Sleep: REM 25-35% Most important 5 stages of sleep
- Rebound sleep
- when REM sleep is decreased strong tendency to make it up Sedative Hypnotics
- Barbiturates
- Reduce oveall CNS alertness Drug tolerance can occur as well as dependence: Ultra short
- Benzodiazepines
- Sedative/hypnotic of choice, low doses reduce anxiety can calm and sedate w/o drowsiness
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Muscoskeletal Relaxants
2 categories - Centrally and Peripherally acting relaxants
-
Centrally Acting
Mechanism of Action
Indications
Contraindications -
Unknown but act by CNS depression
Acute spasms from muscle trauma and drug allergy and renal impairment -
Peripheralor Direct Acting
Mechanism of Action
Indications
Contraindications - acts on muscles min. effect on CNS mild weakness of S.M. and decreases the force of reflex muscle movements & spasticity
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Antiepileptic Agents
Drug Classes -
Benzodiazepines: Lorazepan
BarbituratesL Phenobrbital
Carbamazepine: Tegretol
Valproic acid: Depakene
Topiramate: Topamax
Hydantoins: Dilantin
Succinimides: Ethosuxmide
Gabapentine: Neurontin -
Antiparkinsonian Agents
Parkinson's deisease - A dopamine deficiency occurs in the bal ganglia, slowly progressive degenerative neurologic disorder characterized by resting termor, pill rolling of the fingers shuffling gait muscle rigid and weakness
- Treatment of Parkinson
- Promote secreetion of dopamine and inhibit cholinergic effects with anitcholinergic drugs
-
Antiparkinsonian Agents
Anticholinergic -
benztropine, biperiden, procyclidine, trihexyphenidyl
reduce rigidity and tremors -
Antiparkinsonian Agents
Antihistamines - diphenhydramine, orphenadrine
-
Antiparkinsonian Agents
Dopamine receptor agonists - bromocriptine, levodopa-carbidopa, pergolide, pramipexole, ropinirole, selegiline
-
Antiparkinsonian Agents
Implications - Assist in walking because Dizziness may occur, Force fluids, Avoid foods high in B6 cause reverse of levodopa, MAOI's can cause hypertensive crisis
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Antiparkinsonian Agents
COMT inhibitors - In hibit the enzyme COMT which breaks down dopamine molecules
- Drugs Classes Used in Anxiety Disorders
- Antihistamines and misc. anxiolytic agents Benzodiazepines
-
Benzodiazepines
S/A Effects - drowsiness, hangover, sedation, lethargy, report: abuse, blodd cyscrasisa, and hepatotoxicity
-
Drugs Use in Anxiety Disorders
Benzodiazepines - Xanax, librium, Valium, Diazepam, Lorazepam
-
Drugs Use in Anxiety Disorders
Antihistamines -
Hydroxyzine(vistrail, Atarax)
blurred vision, constipation, dryness of mouth, throuat or nose sedation report dizziness, slurred speech -
Drugs Use in Anxiety Disorders
Azaspirones: - Buspirone (Buspar)partial serotonis agaonist. non habit or sedating
- Antimanic Agents
- Lithium Serum level 1.0 to 1.5 mEq/L levels exceeding 2.0 to 2.5 produce moderate to severe toxicity
- Drug Therapy for depression
- MOAI(Nardil), SSRI (Prozac), Tricyclic (Elavil), Misc (wellbutrin)
-
Antipsychotic Agents
Phenothiazine
(Chlorpromazine) - Low potency agent, Psychotic disorders and schizophrenia
-
Antipsychotic Agents
Thioxanthenes (thiothixene) - High potency, blocks receptors for dopamine, acth, hitaine and morepinephrine I: Sch/otr psy disorder
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Antipsychotic Agents
Butyropheneones
(Haloperidol) - High potency nerolepitcs and blocks receptors for dopamine acth, histamine, and norepinephrine I: Schiz, acute psy, tourettes
-
Antipsychotic Agents
Dihydroindolones
(molindone) - blocks dopamine receptors in the brain for psychotic disorders and schiz
-
Antipsychotic Agents
Atypical antipsychoitcs
(Clozapine) - Bokcs actoin on receptors like serotin, alph adrenergic and histamine for patients with sever schizophrenia risk of fatal agranulocytosis
- Amphetamines
- produce mood elevation or euphoria increase mental alertness adn capacity for work used to treat ADHD and narcolespy
- Anorexiants
- suprrss appetit and tused for exogenous obesity
- Serotonin agonists
- treat migraine headaches by stimulat 5ht1 receptors and constriction of dialted blood vessels in the brain and relas or inflammatory neuropeptides